Dengue fever

Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles.

Dengue (pronounced DENG-gay) strikes people with low levels of immunity. Because it is caused by one of four serotypes of virus, it is possible to get dengue fever multiple times. However, an attack of dengue produces immunity for a lifetime to that particular serotype to which the patient was exposed.

Dengue goes by other names, including "breakbone" or "dandy fever." Victims of dengue often have contortions due to the intense joint and muscle pain, hence the name breakbone fever. Slaves in the West Indies who contracted dengue were said to have dandy fever because of their postures and gait.

Dengue hemorrhagic fever is a more severe form of the viral illness. Manifestations include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red or purple blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.

Diabetes mellitus

"Diabetes" redirects here. For the journal, see Diabetes (journal). See also Diabetes insipidus.
Diabetes mellitus
Classification and external resources

Universal blue circle symbol for diabetes.[1]
ICD-10 E10.–E14.
ICD-9 250
MedlinePlus 001214
eMedicine med/546 emerg/134
MeSH C18.452.394.750
Diabetes mellitus, often simply referred to as diabetes—is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).

There are three main types of diabetes:

Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.)
Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency.
Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.
Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.

Profuse sweating

Patients with high fevers and often patients who are close to death will perspire profusely. Give the patient frequent sponge baths and change bedding as needed.

Labored breathing

The patient who is having difficulty breathing may find relief by being turned slightly on their side with their head propped up on pillows. Sometimes opening a window may also help.

Abdominal distention and constipation

The observant visitor may notice that the patient's abdomen is distended or the patient may complain of constipation to a friend or family member who has the time to listen to their woes. These are common problems when pain-killing drugs are used or when the patient is immobile and they are an additional cause of discomfort and distress. They can usually be relieved with medication or medical interventions. Report these problems.

Mouth care

Adequate care of the mouth is essential. Dentures should fit properly. If they do not, they will cause a sore mouth and difficulty eating. A visit from a dentist is in order if dentures bother the patient.

When a patient is debilitated, frequent mouthwashes are important. Their mouth may drop open and become dry. Water should be given in frequent small quantities if the patient can swallow. The patient should be on their side so that fluid doesn't trickle down their windpipe, making them cough.

Brushing the teeth and tongue with a soft-bristled brush and a small amount of a mild toothpaste and rinsing is helpful.

vomiting

Usually there is a basin for this purpose close at hand. Turn the patient on their side so they will not choke or aspirate the vomitus into their lungs. Hold the basin against their cheek and under their chin. Call for help. Antiemetic drugs can control vomiting.